How do I care for a cat with diabetes?

September 25, 2009 10:17 AM

How do I best care for a cat with diabetes?

A few specific questions:

1. Is it really difficult to inject a cat with insulin?

2. Is insulin necessary if the diabetes isn't severe?

3. Has anyone given their cat metformin pills instead of insulin? What are the advantages and disadvantages of this?

4. Is there anything practical I should know or expect with regard to the cat's behavior, side-effects, etc?

(I am aware of this previous question.)

(Posted for a friend)

Thank you.

posted by dbgrady to pets & animals (15 answers total)

1. No. It's a piece of cake.
2. Sometimes, but we don't know whether your cat needs it or not. Ask your vet.

4. Cat's don't deal with insulin overdoses any better than people do. Talk to the vet about symptoms of hypoglycemia, and be prepared to deal with it. In human diabetics, excess insulin can be countered with a glass of orange juice. In a cat, you may need to have a different shot handy. It's been a couple of years since our diabetic cat died (from cancer, not from the diabetes), and I can't quite remember what that other drug was that we kept on hand. We only had to use it once, I think.
posted by jon1270 at 10:31 AM on September 25, 2009 [1 favorite]

As to the first question, no. My method was as follows:

A) Lay out various items: Fresh needle; insulin from fridge; a towel; a damp, warm washcloth
B) Prepare injection
C) Obtain cat
D) Place towel on lap, cat on towel
E) Pet cat for a while
F) Stroke cat with darm, warm washcloth for a while (simulating parental grooming even more)
G) Pinch up an appropriate bit of that extra cat skin
H) Pop needle into cat skin quickly
I) Depress plunger on needle
J) Remove needle
K) Continue stroking the cat with the warm washcloth as if nothing happened for about five minutes, rubbing the area of injection only a bit
L) Release cat, if the cat wants it

You can practice with an empty syringe on yourself. It's quite easy. You'll notice that it is much less painful to simply pop the needle in with some alacrity, rather than slowly penetrating. For what it's worth, I never noticed a flinch or even a blink from the cat at the moment of injection. It could be that he was a little woozy whenever his insulin was low, but an insulin needle did not hurt me much at all. I even got some sterile solution (Ringer's?) from a nurse friend to see how much the actual introduction of fluid into the tissue would feel — not bad at all.

Basically, you're attempting to trick the cat into responding as if you're grooming off some scab or tick. Social mammals seem to "expect" the occasional sharp pain during grooming. At least, that's my operating guess.
posted by adipocere at 10:34 AM on September 25, 2009

FWIW, adipocere's injection routine was considerably more sophisticated than mine. I would...

A) Grab a disposable syringe from the box
B) Draw insulin into syringe while standing at the open refrigerator, where the insulin vial is stored.
C) Find cat.
D) Grab skin on cat's neck, lift a bit, and inject.

No soothing ever seemed necessary. The cat didn't seem to know that anything unusual had happened.
posted by jon1270 at 10:42 AM on September 25, 2009 [1 favorite]

1. Is it really difficult to inject a cat with insulin?

Depends on the cat and the person administering the insulin. Administering insulin involves a tiny amount of medication in a tiny syringe with a tiny needle under the skin once or twice a day depending upon the prescription and whether or not the cat is eating. Some cats don't even flinch with the injection, others act like they are being tortured. And if the cat's owner is squeamish with needles it could prove to be difficult but it really is easy and IMO anyone can do it.

2. Is insulin necessary if the diabetes isn't severe?

Diabetes management is necessary to prevent the disease from becoming severe. This may involve insulin injections, blood glucose monitoring, and being on top of any changes in the health of the cat that may complicate the diabetes.

3. Has anyone given their cat metformin pills instead of insulin? What are the advantages and disadvantages of this?

I don't have any experience with metformin pills and cats except that I have never seen it prescribed by any of the internal medicine veterinarians I have worked with. This study says that it may or may not work in cats.

4. Is there anything practical I should know or expect with regard to the cat's behavior, side-effects, etc?

If you do not strictly follow your vet's instructions with insulin administration, (including making sure the cat is eating properly) a life threatening drop in blood glucose could occur. Other than that, cats respond differently to diabetes management. In addition to the daily injections, there will be follow up appointments with your vet to monitor the cat's response to treatment and to make adjustments as needed. You may see some behavioral changes if the cat is resistant to the insulin injections, trips to the vet or the blood draws that are necessary.
posted by little miss s at 10:44 AM on September 25, 2009

We gave a cat insulin for around 5 years and it wasn't that big a deal. Getting his shot was required for getting fed and he figured out the connection quickly and after the first couple weeks was very docile about it. Following as exact a schedule as possible (i.e. always the same time(s) of day) seemed to be to his benefit. Toughest part was arranging cat-sitting, if you've got a special friend or relative you can train up and/or someone who's had to do it before, work this out before you need it and it's best if you have at least a couple alternatives, vet boarding is expensive. I think #2 has to be up to the vet, don't know anything about #3. As to #4, we never had a special antidote for insulin overdose so I don't know about that. Be sure to have it checked regularly, after many years and losing a lot of weight our elderly tom basically recovered from his (adult-onset type, definitely linked to pretty severe obesity under the care of his prior owner) diabetes and no longer needed it. A prescription diet also seemed to help a lot. He did not much care for the restricted, no junk diet but the weight loss really helped his health.

Caring for a diabetic cat was not particularly expensive or onerous in the long run and our cat had half a dozen content, mostly healthy years as a result (when the diabetes was getting bad before diagnosis we were pretty convinced we'd be putting him down soon, the treatment was a big health turnaround).
posted by nanojath at 10:44 AM on September 25, 2009 [1 favorite]

Just adding to nanojath's comment--for cat-sitting, if you've got a diabetic friend who's willing to do it, that's the one to ask. My husband is Type 1 and he's on call to care for our friend's diabetic kitty if they go out of town. He's used to dealing with the injection process and that makes it easier on everyone, including the cat.
posted by dlugoczaj at 10:55 AM on September 25, 2009

1. Is it really difficult to inject a cat with insulin?

Not much to add here (every cat is different, but not really a scary thing to do), though I tend to find playing with the cat before/while giving him the shot tends to make him not even react to it (kind of like when you divert attention from the needle while giving a child a shot).

Honestly, I would rather give my cat the insulin shot than attempt to feed him pills. It’s relatively easy and doesn’t require me to put my fingers in his mouth.

2. Is insulin necessary if the diabetes isn't severe?

Go with whatever your vet says.

4. Is there anything practical I should know or expect with regard to the cat's behavior, side-effects, etc?

My vet suggests having a bottle of corn syrup around for excess insulin issues (wiping/shooting it on the gums if he’s reacting, then call the vet). I’ve been giving my cat shots for two years now, and have not had to do this.

Be careful about giving the cat a shot if he’s been vomiting a lot.

Prescription cat food sounds like a huge deal, but it's relatively inexpensive ($50 for a bag that lasts for two-three months) and makes a huge difference.

People at the pharmacy give you strange looks when you pick up medicine for your cat.
posted by dinty_moore at 11:07 AM on September 25, 2009

Just started doing this with my cat - vet said give her the shot while she's eating and when I do that, she's so busy nomming her food that she barely gives me a look when I inject her.

We are still learning her glucose curve so she did go into low blood sugar spin last week - she started walking around in circles, her back legs were sort of draggy and she wouldn't eat or anything. The vet had said to put some maple syrup on her gums to pull her back up to somewhat normal. Took a while (and a vet visit just in case) to get her on track. We stopped the insulin for the weekend, tested her sugar (high again) and re-started at a smaller dose.

Giving the shots is easy-peasy, IMO but I'm not squicked out by needles. Good luck!
posted by Mysticalchick at 11:08 AM on September 25, 2009

There are a couple forums for pet owners of cats with diabetes. One is http://pets.groups.yahoo.com/group/felineswithdiabetes/ and the other is http://pets.groups.yahoo.com/group/DiabeticCatsDM/.

FWIW, (and you should consult your vet of course) our cat got diabetes but her body righted itself when we started to serve her only wet cat food with low carbs. Of course, it all depends on the severity of the disease and there has been discussions on this subject on the lists above. But our vet agreed that cats don't need carbs. They only make them fatter and more prone to the disease.
posted by Taken Outtacontext at 12:02 PM on September 25, 2009

Just chiming in that it's going to depend on your cat, but it's definitely entirely possible that the injections will be no big deal at all. My diabetic cat hardly ever even noticed his injections. Once or twice he squeaked and I assume I had gone in at a weird angle or injected too close to a sore spot from the morning injection or something, but 99% of the time it was fine.

My post in that thread you linked says most of what I would say now on the subject, except that since that time I've investigated the AAA membership I mentioned there. The AAA prescription coverage does in fact also apply to prescription pet medicine; I have another cat on meds and I save a quite decent amount on his medication with the AAA coverage. Definitely enough to more than offset the annual membership cost.
posted by Stacey at 12:21 PM on September 25, 2009

Make sure you check in regularly with your vet. Our diabetic cat got less diabetic as he got older, and needed smaller doses of insulin.

He also stood patiently next to the refrigerator when we opened it for the insulin, and took his injections very stoically. But YCMV.
posted by vickyverky at 1:04 PM on September 25, 2009

My sister-in-law has a diabetic cat, she's been injecting her with insulin going on 12 years now. She also gets special food, though I don't know which brand. Up until abut a year ago there was nothing obvious about her condition but lately she's been having some back leg problems that limit her mobility.

This cat was diabetic as a kitten so with proper management it definitely isn't a limiting factor on lifespan. The only downside is finding a cat sitter willing to inject the insulin (I for one couldn't do it) when she travels.
posted by tommasz at 3:29 PM on September 25, 2009

1. Is it really difficult to inject a cat with insulin?
It was harder for me then it was for my cat. I hate needles, but out cat didn't mind at all. Having set times helped a lot--our cat even came to expect it and would wait for us to give her the shot.

2. Is insulin necessary if the diabetes isn't severe?
nthing talking to you vet. In many cases, you can improve the condition with diet. Our vet said wet food was better, but our can couldn't keep it down. Instead we give her a Diabetes friendly dry food (Purena DM) which has helped keep her in check.

4. Is there anything practical I should know or expect with regard to the cat's behavior, side-effects, etc?

Too much insulin can be dangerous. Keep a close eye on the cat when you start giving her injections, or if you change her food. Make sure the cat eats regularly. Our vet also advised that if there was any question, it was better to err on the side of too little insulin then too much. Watch out for the symptoms Mysticalchick described above, and have something like corn syrup or maple syrup on hand if needed.

The amount of Insulin your cat needs may change over time, especially if you change its diet. You may want to schedule regular checks with the vet until everything is stable. In many cases, you may be able to stop the insulin after a while and manage the diabetes with just diet.

Good Luck!
posted by nalyd at 6:13 AM on September 26, 2009

I can't thank all of you enough for the fine, fine advice. I wish you all the best.

In animal loving solidarity,

David
posted by dbgrady at 8:58 AM on September 26, 2009

adipocere: "You can practice with an empty syringe on yourself. "

DO NOT inject yourself with air from an empty syringe. Use only sterile isotonic saline if you must practice on yourself.
posted by The White Hat at 10:59 AM on September 26, 2009